Program Description

The Albuquerque Service Unit in Albuquerque, New Mexico, offers the Special Diabetes Program for Indians Healthy Heart Demonstration Project at the Albuquerque Indian Health Center and in the field clinics of the Pueblos of Zia, Santa Ana, and Sandia. In addition to the project director and project coordinator, the staff includes a supervising physician, a social worker and certified personal trainer, an IT specialist, four case managers from various disciplines, and a data entry specialist.

Successful Activities

Program staff find that participants enjoy learning about diabetes and cardiovascular disease through the Balancing Your Life and Diabetes and Honoring the Gift of Heart Health curricula. The participants report as particularly helpful the practical tips presented in the Honoring the Gift of Heart Health Curriculum, such as label-reading, reducing sodium by learning how to mix various spices, and making healthy lifestyle changes.

The program also provides cardiovascular disease awareness activities through various health fairs and through a partnership with the Santa Ana Community Wellness Program. Incorporating creative themes has been key to the success of these community outreach and awareness activities. For example, for a recent community outreach activity, a Santa Ana community health representative suggested the theme “Don’t Gamble with Your Health”. This theme was incorporated into every “station” at the health fair; individuals would stop at each station to learn more about diabetes and cardiovascular disease.

The program also formed a partnership with a non-profit organization to offer exercise facilities for American Indians and Alaska Natives living in Albuquerque. The facility, called the New Heart Center, provides exercise equipment, medical supervision (if necessary), and instruction on how to use the equipment.

Elements of Success

Case managers from various disciplines (e.g., nursing, pharmacy and nutrition) take turns accepting new participants.

Case managers are able to refer participants to other case managers when necessary to meet participants’ individual needs.

The multidisciplinary case management team allows the case managers to share a variety of perspectives and recommendations during team meetings.